Provider Demographics
NPI:1265403935
Name:KAUFMAN, JODI D (MD)
Entity type:Individual
Prefix:DR
First Name:JODI
Middle Name:D
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:147 E 3RD ST
Practice Address - Street 2:SUITE ONE
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-2924
Practice Address - Country:US
Practice Address - Phone:856-234-7754
Practice Address - Fax:856-234-2290
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2022-01-18
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Provider Licenses
StateLicense IDTaxonomies
NJMA56789207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5178401Medicaid
NJ1039728OtherHORIZON NJ HEALTH
NJ000619079OtherIND BC PPO
NJ0448369000OtherAMERIHEALTH/KHPE/IND BCBS
NJ0500085001OtherAMERIHEALTH KHPE IND BC
NJ3126555OtherCIGNA
NJOK2157OtherPHS
NJ5178401OtherUNISYS
NJ110046661OtherRAILROAD MEDICARE
NJ4662898OtherAETNA
NJP395156OtherOXFORD
NJE54613Medicare UPIN